Fill Out a Valid Georgia 57 Template Edit Georgia 57 Here

Fill Out a Valid Georgia 57 Template

The Georgia 57 form serves as a critical document for the Child Care and Parent Services (CAPS) program within the Georgia Department of Human Resources. It is designed to facilitate childcare referral and application for supplemental supervision for children in foster care. By detailing foster child information, foster care placement, child care provider specifics, and eligibility determination, it ensures a structured approach to support service access.

Edit Georgia 57 Here

Embarking on the path of understanding child care services in Georgia, particularly for those in foster care, introduces the pivotal role of the Georgia 57 Form. This document, crafted by the CAPS (Childcare and Parent Services) division of the Georgia Department of Human Resources, serves as a linchpin in ensuring that foster children receive the supplemental supervision and care they need. Its sections are meticulously designed to collect pertinent information ranging from the foster child's basic records, including name, sex, date of birth, and social security number to more detailed queries about the child's educational setting, any disabilities, and ethnic background. This form not only aims to capture the foster child's data but also traces the necessary details about the foster care placement, including names and contact information of the foster parents, along with the childcare provider's details. It thoughtfully considers whether the care provided will be by relatives or non-relatives and the location of the care. Furthermore, the form delves into the technical aspects of childcare provision, such as eligibility determination, laying out a structured framework to assess the family unit size, the associated cost of care versus the maximum rates defined by DFCS, and the official certification period for the provided childcare. Its comprehensive design guarantees that every child in the foster care system has access to dependable and consistent childcare, underpinning the commitment of Georgia's Department of Human Resources to safeguard the welfare and development of its youngest and most vulnerable constituents.

Form Example

Date Received by CAPS

Georgia Department of Human Resources

CHILD CARE REFERRAL & APPLICATION FOR SUPPLEMENTAL SUPERVISION

___________ County Department of Family and Children Services

A. FOSTER CHILD INFORMATION (To be completed by SSCM)

First Name MI Last Name Sex

Date

Social Security

Child

Child

of

Number

in

in

Birth

 

School

Pre-K

 

 

 

 

Child

in

Head

Start

Child has a disability

Ethnicity (check one):

Hispanic

Not Hispanic

 

Race (check one):

White

Black/African American

Asian

 

American Indian or Alaskan Native

Native Hawaiian or other Pacific Islander

B. FOSTER CARE PLACEMENT INFORMATION (To be completed by SSCM)

Foster Parent's Name

Address

Home Phone

 

 

 

Work Phone #

 

 

 

 

If an informal childcare provider has been chosen, check all that apply:

 

Relative of Child

Care provided in child's home

 

CRC completed

Non-Relative

Care provided in provider's home

 

CPS screening completed

 

 

 

Approved by Foster Care

 

 

 

 

All changes in the child's placement and child care arrangements MUST be reported to the child care case manager within 5 working days.

____________________________________

________________

_______________

Signature of Foster Care Case Manager

Date

Case Load ID #

C. CHILD CARE PROVIDER INFORMATION (To be completed by the SSCM or Foster Parent)

Reason Care is Needed:

Days and Hours Care is Needed:

Date to begin CAPS: _____

Name, Address and Phone # of Childcare Provider:

Phone # :

D. ELIGIBILITY DETERMINATION (To be completed by the CAPS case manager)

1.

Family Unit Size

____

 

4.

Rate Within DFCS Maximum?

Yes

No

2.

UAS Code (check one):

 

 

 

Cost of care if not within maximum $_________

 

 

555 (Pre-K)

557

 

 

 

 

 

3.

Provider is:

 

 

5.

Application Disposition:

Approved

Denied

 

Licensed, Commissioned, or Exempt

 

 

 

 

 

 

 

Registered

 

 

6.

Official Certification Period:

 

 

 

 

Informal- Relative of Child

 

 

___________________ to __________________

 

Informal- Non-Relative

 

 

 

 

 

 

 

Comments:

________________________________

_____________________

_____________________

Signature of CAPS Case Manager

Date

CAPS Case Load ID #

Form 57 (3/2004)

Page 1 of 1

Document Details

Fact Name Description
Form Title Georgia 57 Form: CHILD CARE REFERRAL & APPLICATION FOR SUPPLEMENTAL SUPERVISION
Intended Use Used for children in foster care to apply for supplemental supervision/care.
Sections Included Includes sections for Foster Child Information, Foster Care Placement Information, Child Care Provider Information, and Eligibility Determination.
Governing Law Regulated by the Georgia Department of Human Resources, adhering to state-specific laws regarding child care and foster care services.
Special Conditions Requires reporting any changes in the child's placement or care arrangements to the child care case manager within 5 working days.
Eligibility Criteria Addresses the family unit size, UAS Code for the type of care needed, the provider's credential status, and final application disposition.

Detailed Guide for Using Georgia 57

Filling out the Georgia 57 form is an essential step for securing supplemental supervision and childcare referrals for foster children within the state. It involves providing detailed information about the foster child, the foster care placement, choosing a childcare provider, and awaiting eligibility determination by the CAPS case manager. This step-by-step guide aims to simplify the process, enabling foster care case managers and foster parents to complete the form efficiently and accurately.

  1. Start with Section A: FOSTER CHILD INFORMATION. Fill in the foster child's first name, middle initial (MI), and last name. Specify the child's sex, date of birth, social security number, and check the relevant boxes to indicate if the child is in school, in Pre-K, in Head Start, has a disability, and specify the child's ethnicity and race by checking the appropriate box.
  2. Move to Section B: FOSTER CARE PLACEMENT INFORMATION. Enter the foster parent's name, address, home phone number, and work phone number. If an informal childcare provider has been chosen, indicate the relationship to the child and where the care will be provided. Ensure to check the boxes if a CRC or CPS screening has been completed and if the choice has been approved by Foster Care. Remember, any changes in placement or care arrangements must be reported within 5 business days.
  3. In the signature field at the bottom of Section B, the foster care case manager should sign and provide the date along with their Case Load ID#.
  4. Proceed to Section C: CHILD CARE PROVIDER INFORMATION. This section should be filled out by the SSCM or the foster parent. Detail the reason why care is needed, the days and hours the care is needed, the date to start CAPS, and provide the chosen childcare provider’s name, address, and phone number.
  5. Lastly, Section D: ELIGIBILITY DETERMINATION is for the CAPS case manager to complete. It includes detailing the family unit size, checking the appropriate UAS Code that applies, deciding whether the provider is licensed, commissioned, exempt, or registered, and if the rate falls within the DFCS maximum. The application disposition should be marked as approved or denied, along with setting the official certification period for the approval. Comments can be added for any additional information. The CAPS case manager then signs the form, dates it, and includes their CAPS Case Load ID#.

After the form is duly filled, the next step usually involves submission to the relevant department for processing. The information provided will undergo review for eligibility and determination for the supplemental supervision and childcare referral. Timely and accurate completion of the Georgia 57 form is crucial in ensuring that foster children receive the required care and supervision without unnecessary delays.

More About Georgia 57

  1. What is the Georgia 57 form?

    The Georgia 57 form is a document used by the Georgia Department of Human Resources to apply for child care referral and supplemental supervision. It is specifically designed for use within the childcare assistance for foster children under the care of the State, ensuring their needs for education, disability support, and overall welfare are met through adequate childcare arrangements.

  2. Who needs to complete the Georgia 57 form?

    The form is filled out by the Special Service Case Manager (SSCM) and foster parents. It collects details about the foster child, the foster care placement, the childcare provider, and requires an eligibility determination by the Childcare and Parent Services (CAPS) case manager.

  3. What is the process to file a Georgia 57 form?

    Filing the Georgia 57 form involves several steps. Initially, the foster child's SSCM fills out the section with the child's personal information, followed by the foster care placement information. If a foster parent or SSCM has selected a child care provider, that information is also included. Finally, the CAPS case manager reviews and completes the eligibility determination. All parties must sign their respective sections before submission within the required timelines.

  4. Can changes be made to the childcare arrangements after submitting the Georgia 57 form?

    Yes, changes in the child's placement and child care arrangements can be made after submitting the form. However, these changes must be reported to the child care case manager within 5 working days to ensure the child’s welfare and care are continuously managed without interruption.

  5. What happens if the cost of care exceeds the DFCS maximum rate?

    If the cost of care exceeds the Department of Family and Children Services (DFCS) maximum rate, the specific amount that goes beyond the maximum must be documented in the Georgia 57 form. This information aids in assessing the need for additional funding or adjusting childcare arrangements to meet financial constraints.

  6. What are the eligibility determinations made by the CAPS case manager on the form?

    The CAPS case manager assesses the application based on several criteria including the family unit size, the cost of childcare, and whether the childcare provider meets the necessary licensing or registration requirements. The case manager then approves or denies the application and sets an official certification period for the childcare services.

  7. How does one choose a childcare provider on the Georgia 57 form?

    When filling out the Georgia 57 form, choices for informal childcare providers include selecting a relative of the child or a non-relative. Care could be provided in the child's home or the provider's home, with the necessary checks such as Child Protective Services (CPS) screening and Criminal Records Check (CRC) completed as needed. The chosen setting and provider must be approved by Foster Care.

  8. What significance does the UAS code hold in the Georgia 57 form?

    United Assessment System (UAS) codes, such as 555 for Pre-K, help categorize the type of care or subsidy a child is eligible for, based on their specific needs and circumstances. This categorization is crucial for the CAPS case manager in making accurate eligibility determinations and ensuring children receive appropriate care.

  9. What documentation is required for the Georgia 57 form?

    Documentation required for the Georgia 57 form includes identification and residency information for the foster child, details about the foster care placement, and selections for childcare providers including proof of their licensing or registration. Additionally, signatures from the SSCM, foster parents, and the CAPS case manager are necessary to confirm the accuracy of the information provided.

  10. How are disabilities handled in the childcare arrangement process?

    Children with disabilities are given special consideration in the childcare arrangement process. The form requires disclosing whether the child has a disability, which helps in determining the need for specialized care or support services. This ensures that all children, regardless of their abilities, receive adequate care tailored to their individual needs.

Common mistakes

When filling out the Georgia 57 form, which is crucial for Child Care Referral & Application for Supplemental Supervision through the Georgia Department of Human Resources, individuals often encounter pitfalls that can potentially delay or affect the approval process. Understanding and avoiding these common mistakes can streamline the application process and ensure timely assistance.

  1. Not fully completing the foster child information section (Section A). It's essential to provide detailed information including the child's first name, middle initial, last name, sex, date of birth, social security number, and specific details regarding schooling and disability status. Omitting any of this information can result in processing delays.

  2. Incorrectly filling out the foster care placement information (Section B). This section requires accurate details about the foster parent, including name, address, and phone numbers. Also, if an informal childcare provider is chosen, correctly indicating the relationship to the child and whether certain screenings have been completed is critical. Failure to accurately report changes in the child’s placement and childcare arrangements within 5 working days can also lead to issues.

  3. Failing to specify the reason and schedule for needed care in the child care provider information section (Section C). Clear communication about the days and hours care is needed, as well as the expected start date, helps the CAPS case manager understand the urgency and nature of the needed care.

  4. Overlooking the eligibility determination section (Section D). This section must be filled out by the CAPS case manager, but foster parents and SSCMs should ensure that the family unit size, UAS code, type of provider, and cost of care are properly documented and fall within DFCS maximum rates where applicable.

  5. Signing without reviewing. The final step, which requires the signatures of both the Foster Care Case Manager and the CAPS Case Manager, is often rushed. It is imperative to review all the information provided in the form to ensure its accuracy before signing.

By paying close attention to the details and requirements outlined in the Georgia 57 form, individuals can avoid these common mistakes. This attention to detail not only demonstrates a commitment to compliance but also helps in securing the best possible care and supervision for children in foster care.

Documents used along the form

When dealing with the complex realm of childcare and foster care in Georgia, the Georgia 57 form serves as a crucial document for applying for supplemental supervision. This form is just one of many documents necessary to navigate the system effectively. Accompanying forms and documents often used along with Georgia Form 57 enhance its application, ensuring a cohesive approach to child welfare and care services. The following is a list of documents typically utilized alongside the Georgia 57 form, each playing a vital role in the application process, determining eligibility, and facilitating the provision of services.

  • Form 297 (Child Care Plan): Outlines the specific care needs and schedules for the child, including educational and health-related accommodations.
  • Form 330 (Foster Care Agreement): A contract between the foster parents and the agency detailing the responsibilities of each party towards the foster child.
  • Medical Consent Form: Grants the foster parents the authority to make medical decisions on behalf of the child in their care.
  • Form 103 (Case History Summary): Provides a comprehensive overview of the child’s background, including family history, previous placements, and pertinent medical and educational information.
  • Form 220 (Placement Assessment): Assesses the suitability of the foster home environment for the child in question.
  • Educational Records Release Form: Allows for the transfer of the child’s school records between educational institutions.
  • Form 118 (Provider Compliance Form): Used to verify that a childcare provider complies with state regulations and standards.
  • Income Verification Forms: Required to determine the eligibility of the child for certain programs based on the foster family’s income.
  • Form 88 (Foster Parent Training Records): Documents the training that foster parents have received, ensuring they are prepared for the challenges of fostering.

Understanding and completing these documents is essential for foster care providers, social workers, and officers within the Georgia Department of Human Resources. They ensure that every child placed in foster care receives the appropriate support, care, and services tailored to their unique needs. This comprehensive approach to documentation facilitates a seamless, efficient process that upholds the best interests of the child, aligning with Georgia's commitment to child welfare.

Similar forms

The Georgia 57 form is similar to the Child Care Assistance Application used in many states for enrolling children into subsidized child care programs. Both documents are crucial in determining eligibility for child care assistance, often serving families that need financial support to afford quality child care. They collect detailed information on the child's family situation, care needs, and the type of care sought, whether it's in a family home or a licensed child care center. The emphasis is on the child's safety, well-being, and developmental needs. Moreover, both forms typically require details about the child care provider, such as name, address, and phone number, and undergo a verification process to ensure the provider meets state standards. These forms also share a similar section for official use, where case managers document the eligibility determination, including approval status and the certification period for the child care assistance.

Another document the Georgia 57 form is akin to is the Foster Care Placement Agreement. This resemblance is seen primarily in the sections that detail the foster child's placement information and the foster care case manager's signature, which are vital for any child placement documentation. Like the Georgia 57 form, the Foster Care Placement Agreement requires comprehensive information about the foster child, including personal identifiers and placement settings. However, while the Georgia 57 form specifically addresses child care arrangements and supplemental supervision within the broader context of foster care, the Foster Care Placement Agreement focuses more on the terms and conditions of the foster care placement itself. Both forms serve as binding documents that formalize the arrangement between foster families and the overseeing agency, ensuring that the foster child's needs are met in a supportive, safe environment.

Dos and Don'ts

When filling out the Georgia 57 form, which is designed for child care referral and application for supplemental supervision in the context of foster care, there are key practices to follow as well as pitfalls to avoid. This ensures that all the required information is accurately captured, facilitating the smooth processing of the application.

Do:
  • Review the entire form before starting. Ensure you understand what is required in each section to avoid errors or omissions.
  • Provide accurate and up-to-date information. For sections such as the foster child's information and the foster care placement details, make sure all data is current and correctly entered.
  • Use black ink or type your responses. This makes your answers easier to read and reduces the risk of processing errors.
  • Consult with a CAPS (Childcare and Parent Services) case manager for any questions. If you're unsure about any part of the form, seeking clarification can help prevent mistakes.
  • Sign and date the form where required. Your signature validates the information provided and is a critical requirement for processing.
Don't:
  • Omit crucial details. Failing to fill out any part of the form, especially concerning eligibility determination, can delay processing.
  • Guess information. If you're uncertain about specific details, it's better to seek accurate information rather than making assumptions.
  • Use pencil or colored inks. These can smudge or fade, making your application difficult to read and potentially affecting its processing.
  • Forget to report changes in the child's placement or care arrangements within 5 working days. Timely updates are essential for maintaining accurate records and ensuring continued eligibility.

By following these guidelines, applicants can facilitate a smoother and more efficient processing of the Georgia 57 form, ultimately ensuring that foster children receive the necessary child care services in a timely manner.

Misconceptions

Misconceptions often arise when it comes to understanding specific documents. The Georgia 57 form, a critical piece in the child care referral and application process for supplemental supervision under the Georgia Department of Human Resources, is no exception. Here, four common misunderstandings are clarified to provide a clearer view of its purpose and usage.

  • Misconception 1: The Georgia 57 form is only for foster parents to fill out.
  • This is a common misunderstanding. While foster parents do provide essential information, especially in section B regarding foster care placement, the form also requires input from the SSCM (Service Coordinator Case Manager) for sections related to the foster child's information and child care provider details. Even CAPS (Childcare and Parent Services) case managers fill out a portion, making it a collaborative document.

  • Misconception 2: Any childcare provider can be selected for the child’s care.
  • Another misunderstanding is that foster parents or SSCMs have absolute freedom in selecting a childcare provider. Section C and D clarify that selected childcare providers must meet specific eligibility criteria, such as being licensed, commissioned, or exempt registered. Informal care, whether by a relative or non-relative, must be approved by foster care, and all options need a thorough screening process.

  • Misconception 3: The form serves as an immediate approval for child care services.
  • The form is indeed an integral part of the application process for supplemental supervised child care. However, submitting the form doesn't guarantee immediate approval. Section D, titled 'ELIGIBILITY DETERMINATION', involves a detailed review process by a CAPS case manager, including family unit size, care provider status, and overall cost considerations against DFCS maximum limits.

  • Misconception 4: Once submitted, no further updates are necessary.
  • It's crucial to understand that any changes in the child's placement or child care arrangements require immediate reporting to the child care case manager within 5 working days. This is vital for maintaining an up-to-date understanding of the child's care situation and ensures continuous and proper support.

Correcting these misconceptions about the Georgia 57 form is vital for all involved parties to navigate the processes of securing and updating supplemental child care supervision effectively. It underscores the importance of detailed cooperation among foster parents, SSCMs, and CAPS case managers to support the well-being and care of foster children within Georgia.

Key takeaways

The Georgia 57 form is a critical document used in the State of Georgia to facilitate and manage child care referrals and supplemental supervision for foster children. When filling out and using this form, several key points must be kept in mind to ensure that it is completed accurately and effectively. Below are five key takeaways regarding the Georgia 57 form.

  • The form is divided into four main sections: Foster Child Information, Foster Care Placement Information, Child Care Provider Information, and Eligibility Determination. Each section requires information from different parties involved in the care of the foster child, including the SSCM (Special Services Case Manager), foster parents, and the CAPS (Childcare and Parent Services) case manager.
  • In the Foster Child Information section, it is essential to provide detailed information about the foster child, including their name, sex, date of birth, social security number, school details, and any disabilities. The child's ethnicity and race must also be indicated, highlighting the need for a thorough understanding of the child's background and identity.
  • The Foster Care Placement Information section focuses on the living and care arrangements of the foster child. It requires the foster parent's details and information on whether an informal childcare provider has been chosen. If a provider is selected, details about the relationship to the child, location of care, and whether specific screenings were completed must be provided. Notably, any changes in the child's placement and child care arrangements must be reported within five working days.
  • When completing the Child Care Provider Information, the reason care is needed, along with the days and hours the care is required, should be clearly specified. Information on the child care provider, including their name, address, and phone number, is also required. This section facilitates the connection between the foster child's needs and the provider's ability to meet those needs.
  • The Eligibility Determination section is completed by the CAPS case manager and involves assessing whether the child care arrangement meets the Department of Family and Children Services' standards and requirements. This includes determining the family unit size, UAS code, provider type, and whether the cost of care is within the DFCS maximum rates. The official certification period for the child care arrangement is also established in this section.

Understanding these key elements of the Georgia 57 form can streamline the process of securing appropriate child care for foster children, ensuring their needs are adequately met in a timely and organized manner. It is a vital instrument in the collaboration between foster care case managers, foster parents, and child care providers within the state of Georgia.

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